Yohden Hall Care Complex

Yohden Hall Care Complex is a nursing care home providing personal and nursing care to 77 people. The service is split into four units and one unit accommodates up to ten people with a learning disability. At the time of the inspection there were 53 people using the service.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

People’s experience of using this service and what we found

Right Support:

Yohden Hall Care Complex is a large home which is separated into four different units. The unit that supported people with a learning disability had ten available rooms. This is larger than current best practice guidance. Effective infection and control prevention protocols were not in place on the first day of inspection. Staff did not always respond quickly to assess the safety of medicines. The management support team addressed these matters immediately. People received their medication as prescribed. Staff supported people to access external healthcare professionals when needed. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care:

The provider had systems in place to ensure people were protected from the risk of abuse and harm. Staff were kind to people and treated them with empathy. Environmental and individual risks were identified and managed. The provider was completing a review of care records to make improvements.

Right Culture:

Quality assurance systems were effective. The provider had recognised failings in the home via their quality assurance systems and had started to address the issues identified. The provider responded quickly when extra support was needed in the home to ensure people received good quality and safe care. Whilst the management support team had strong presence in the home, individual units lacked leadership, for example IPC management was poor on our first day. The management support team gave staff clear guidance on where improvements were needed and how these were to be achieved. The management team were in the process of making improvements to the service. These were not fully embedded therefore evidence was not available to confirm the changes were effective or would be sustained.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published 4 February 2020)

Why we inspected

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We received concerns in relation to the management of medicines and staffing. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

All visitors had a temperature check and completed a health declaration before entry. There were ample PPE and handwashing facilities available.

The home supported relatives to visit their loved ones in-line with national guidance. This included visitors being tested for COVID-19 on arrival.

The home was clean, and staff were regularly cleaning frequently touched surfaces.

Staff had received guidance on correct PPE use and were following this. Staff had guidance from an ‘infection prevention and control champion’, a member of staff nominated to share best practice.

The registered manager praised staff for the positive atmosphere in the home and the commitment they had shown throughout the pandemic.

Staff spoke highly of the registered manager and deputy manager and told us they felt supported in their roles.

Yohden Hall Care Complex is a nursing and residential care home accommodating up to 77 people. Care is provided for younger adults, people aged 65 and over, some of whom are living with dementia and people with learning disabilities. Care is delivered across three separate units. At the time of this inspection there were 59 people living at the service.

Services for people with learning disabilities and or autism are supported

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than most domestic style properties. However, the service was separated into three different units. The unit that supported people with a learning disability had ten available rooms. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design.

People’s experience of using this service and what we found

People felt safe and well supported. They were consistently positive about the care they received. The service had a ‘homely feel’ for people to live and visit. There was enough suitable staff to provide people with the support they required. People received their medication safely.

People’s health care needs were met. The service worked in partnership with the appropriate health professionals. Food and fluids were always available to people and people’s relatives enjoyed joining them for meal times.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People told us they received a person-centred service. They were fully involved in making decisions about their care. People had the option to participate in a variety of activities and were supported to access the local community.

Staff were kind and caring. It was clear people had developed positive relationships with staff who knew them well. Staff maintained people’s privacy and dignity.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Managers and staff enjoyed their work, and were highly motivated, kind and compassionate. There was good staff morale and team work. Staff felt well supported by the registered manager.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 2 July 2016). There was also an inspection on 28 and 29 November 2018. However, the report following that inspection was withdrawn as there was an issue with some of the information that we gathered.

Why we inspected

This is a planned re-inspection because of the issue highlighted above.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Yohden Hall Care Complex was last inspected by CQC on 29 August 2013 and was compliant with the regulations in force at the time.

Yohden Hall Care Complex is a care home with nursing that is registered to provide care for up to 77 people and the majority of the bedrooms were en-suite. On the day of our inspection there were 68 people using the service. The home is located in Blackhall near Hartlepool and is owned and run by Countrywide Care Homes Limited.

Accommodation is provided at ground and first floor levels. The Hall provides care for general residential and general nursing service users. The Lodge provides care for service users with dementia type illnesses. The Court provides care for service users with learning disabilities. Facilities included several lounges and dining rooms, communal bathrooms, shower rooms and toilets, hairdressing rooms, treatment rooms, a communal bar and several communal gardens. The general reception was large and spacious with a comfortable seated area.

We saw that entry to the premises was controlled by key-pad entry and all visitors were required to sign in. This meant the registered provider had appropriate security measures in place to ensure the safety of the people who used the service.

People who used the service and their relatives were complimentary about the standard of care at Yohden Hall Care Complex. We saw staff supporting and helping to maintain people’s independence. People were encouraged to care for themselves where possible. Staff treated people with dignity and respect.

The registered provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff. There were sufficient numbers of staff on duty in order to meet the needs of people using the service.

Training records were up to date and staff received supervisions and appraisals, which meant that staff were properly supported to provide care to people who used the service.

The layout of the building provided adequate space for people with walking aids or wheelchairs to mobilise safely around the home and was suitably designed for people with dementia type conditions.

The service was working within the principles of the Mental Capacity Act 2005 and any conditions on authorisations to deprive a person of their liberty were being met. All the care records we looked at contained evidence of consent.

People were protected against the risks associated with the unsafe use and management of medicines.

People had access to food and drink throughout the day and we saw staff supporting people at meal times when required.

People who used the service had access to a range of activities in the home.

All the care records we looked at showed people’s needs were assessed. Care plans and risk assessments were in place when required and daily records were up to date. Care plans were written in a person centred way and were reviewed regularly.

We saw staff used a range of assessment tools and kept clear records about how care was to be delivered and people who used the service had access to healthcare services and received ongoing healthcare support.

The registered provider had a complaints policy and procedure in place and complaints were fully investigated.

The registered provider had a robust quality assurance system in place and gathered information about the quality of their service from a variety of sources.

People were asked for their consent before they received any care or treatment. The staff we spoke with understood the need for people to consent to the care they provided. It was evident that people were asked about their choices and staff were careful to make sure what they asked was understood.

People told us they were happy with the care and support they received. One relative told us 'I find care here is very good, in fact I find the place uplifting, and I never leave feeling sad. Staff are really pleasant and caring.'

There was enough equipment to promote the independence and comfort of people who used the service. We saw equipment was stored safely and securely throughout the home.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. One relative told us 'The staff know everything about them' and 'They (the staff) understand them here.' Other comments about the staff and people's experience of them included 'The staff are very pleasant and will do anything you ask' and 'Staff are really pleasant and caring.'

The provider had an effective system to regularly assess and monitor the quality of service that people received. We found systems were in place to capture feedback from people who used the services, their relatives and representatives.